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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00060 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/26/2011 c Parcel: 1 S 135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 360 Project: Ameriprise Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0 Project Description: Phase 2, TI, (3) branch circuits. Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC 11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503 - 255 -9488 PHONE: FAX: 503 - 257 -7121 FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 01/26/2011 $71.02 Specifics: Service or Feeder 1 ea 12% State Surcharge - 01/26/2011 $8.52 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 thr gh OAR 952 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 987 or 1.800.332.2344, Issued By:/ f0 o.� . , Permittee Signature: i' ✓�����J OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY _��� SIGNATURE OF SUPR. ELEC' �� /mod /!rf Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 01/25/2011 15:16 5032577121 CAPITOL ELECTRIC PAGE 02/02 IeCtriCal a B X' � � tiL"1 X+01 t . Received / Petmitno.; �d�C�� City of Tigard %. , 1 ` Uatc /By; / ! � ' tt ' PlanRcvicw OthcrPclZltil; li ° 1.3123 SW Hall Blvd., Tigard, O � p ' �' sate /13y: Phano; 5D3 630, Fax: 50%59,,,W 011 — Nod f+cd(Method: �— Dale Iur U sec race lm T1 A � + � k,, CrAR)7 Inspection Line: ; 503,t39.4i 75 V ^� Suplltmenla{ Inm,'maiion interact: www.tigard vr.Sov p� .... . nt✓ Tl�•1t°a° ° — PLAN REVIEW TYPE OF WORK C\ 1 _ �,�i‘� D1v Li _ tt u Ploase check all that apply (submit 2 seiO of pleas w/ltome checked below): 0 New c l I Of l ucl;on [' Other; [Ti Service or feeder 400 amps or more rton(altcralion /rcpt C ;�l�� \tip LI gulldln over tome stodn° Othe 9 ❑ Demolition r — J where the: avallohle Mull currant l� Marine: and boatyardo CATEGORY OF CONSTRUCTION nxceeds 10,000 amps at t50 vats or Floating buildings 1 -and 2- finally thvelting J Commercial /induslr;al Li Accessory building less to ground, or exceeds 14,000 Commnrclal -use agricultural ❑ Mul1i- family L] Ma ster Builder L Other amps for all other instalietier.. l] buildings JOB SITE MFORMATtpty AND LOCATION ❑ Fire Pump ❑ Installation of 75 KVA or 101271 I Job site address: — 10200 SW Greenburg Rd ❑ Emergency system largor separately derive syem. Jot n0 L� "A" "5" "1 : 2" "1 -3" ❑ Addition of new motor load of 100NP or more. L] occupancy City /Statc!'LIP: Tigard OR �— n Recreational vehicle ?arks, -- ❑ Six or more residential units [ PnCIICCI A name: roeriprlge Phase 2 CI Suply volt e for mnrc than tc/blds. /apt. nn.: 360 CI Health-csrc facilities El Huiardouslocations 7 G00 volts nominal. Cron Su'cce /nircctions to job site, ❑ Scrvicc or feeder 600 amps or more FEE SCHEDULE Lot n0.: Description 0 ' 1 '. MM.= •^ $ubdiviainn: New residential single or rhniti- family dWClling unit. Tax ma /. n.: arcel n DESCRIPTION OF WO7 includes nttachedara0e. _ 1000 y , R. or less $ 1E5.'4 4 Mist Tt work ________2_2:,94_,_______:1 La, AdJ'l SOD sq. ft or portion I _ — LI TENANT Limited energy residential 2 _ pROPCRTY OWNER (with above sq, R.1. Si 75.00 Name; Limited energy, multi- family ----- re identiaiwith above a' q- ftJ S 75.00 Addretis, Service nr feeders installation alteration, and/or relocation 2 200 amps or less — $ 100.70 r City/Stole/ZIP; City/Stole/ZIP; 201 amps to 400 amps 133 2 401 am.s to 600 am.s $ 200.31 amps or volts a 0 1 Phone; 1000 Fax: 601 amps to 1000 amps _ $ 301.04 2 52. Owner instnlintion; This installation is being made on property that 1 own which is not Over Over ver 1 00 a services or feeders installntiml, niteratlo, 20 , 2 3 5 and 52. irnietidod for sale. Iease, rent or exchange, according to ORS 447, 449, 670, and 701 rcincntlnn . Dote: g 59.16 ! Owner signature: — 200 amps or Ices 2 CONTACT PERSON 201 amps (9 400 amps 2 APPLICANT $ 125 _ 4 01 amps to 599 amps a . $ 168,54 Business Name' ©ranch c - new, niteralinn, or ez tenslon, cr nu _ A. Pee for branch circuits with Contact name: service or feeder fee, each branch circuit 5 7.42 2 _ Address; B. Fee for branch circuits without service or feeder lee, --- City /S1ntc171P: first branch circuit 1 3 56,10 56.18 2 _ Each a 2 dditional branch circuit: 1 $ 7,42 , 14.84 2 Phone: Fax; Miscellaneous Scrvicc or reeler not inClndcd _ Each manufactured or modular 2 E -mail dwcllin•, service and or feeder $ 67 -R4 CONTRACT OR — Reconnect only 0 67.01 2 Pump or irrigation circle S 07.04 2 Business Name: CAPITOL ELECTRIC CO., INC, $ 07 A4 2 — Si nor outlin li hfin Contael. name: - Signal Circuit(S) OT Ijmited energy panel, alterations. or MARX ST 11401 NE . Address, energy 1. Describe: Fire Alarm 9 75,00 2 P�c2 W City /Rtatc /7th: PQRTLAND, OR 97220 -1!141 Each additional Inspection over allowable In any of the chow _ — nsp inspection 9 ri6.25 Pcr — Phnnc: 5D3.255 -946$ Fax: 503 - 257 -7121 er n i sties er hour I itr min 5 65 5 lndustr;al lant perhour $ 78.1P w • C'Ct3 Lie,; -0.8745 r.lecuicsl Liu.: 26-496C Su.rv. Lic.; 313 ELECTRICAL pPRM1T FEES* �� Sultry. Electrician signature, required: Subtotal $ 71.02 Penn review (15 ° / of c 7+ it fcc Print Name: DA ELL MCNEEL Dom 01125111 State surchar ( l2 % of permit fee) $ 8.52 Authorirc(I signature � Ai TOTAL PERMIT PEE — 7954 Tab permit appllcntitrn expire. Ira permit h em nbinlnv i wnu+n 180 t / Print Nanlc; DARRELL M CNEEL days nrtnr It has fn.. accepted as ,complete, (Jy * Numlfer of inspections per permit allnnied,